Rodríguez Grande, CristinaHurtado, Juan CarlosRodríguez Maus, SandraCasas, IsaacCastillo, PaolaNavarro, MireiaRakislova, NataliaGarcía-Basteiro, Alberto L.Carrilho, CarlaFernandes, FabiolaLovane, LuciliaJordao, DercioIsmail, Mamudo RafikLorenzoni, CesaltinaCossa, AnelsioMandomando, InácioBassat Orellana, QuiqueMenéndez, ClaraOrdi i Majà, JaumeMuñoz, PatriciaPérez Lago, LauraGarcía de Viedma, DaríoMartínez Yoldi, Miguel Julián2022-05-092022-05-092021-06-111198-743Xhttps://hdl.handle.net/2445/185442Objectives: To characterize the clonal complexity in Mycobacterium tuberculosis (MTB) infections considering factors that help maximize the detection of coexisting strains/variants. Methods: Genotypic analysis by Mycobacterial Interspersed Repetitive-Unit-Variable-Number Tandem-Repeats (MIRU-VNTR) was performed directly on 70 biopsy specimens from two or more different tissues involving 28 tuberculosis cases diagnosed post-mortem in Mozambique, a country with a high tuberculosis burden. Results: Genotypic data from isolates collected from two or more tissues were obtained for 23 of the 28 cases (82.1%), allowing the analysis of within-patient diversity. MIRU-VNTR analysis revealed clonal diversity in ten cases (35.7%). Five cases showed allelic differences in three or more loci, suggesting mixed infection with two different strains. In half of the cases showing within-host diversity, one of the specimens associated with clonal heterogeneity was brain tissue. Conclusions: Direct MTB genotyping from post-mortem tissue samples revealed a frequent within-host Mycobacterium tuberculosis diversity, including mixed and polyclonal infections. Most of this diversity would have been overlooked if only standard analysis of respiratory specimens had been performed.5 p.application/pdfengcc by (c) Rodríguez Grande, Cristina et al., 2021http://creativecommons.org/licenses/by/3.0/es/Mycobacterium tuberculosisÀfrica orientalGenètica bacterianaAutòpsiaAnàlisiMycobacterium tuberculosisEast AfricaBacterial geneticsAutopsyAssayingHigh within-host diversity found from direct genotyping on post-mortem tuberculosis specimens in a high-burden settinginfo:eu-repo/semantics/article7195252022-05-09info:eu-repo/semantics/openAccess34119641